Photobiomodulation Therapy to Treat Snakebites Caused by Bothrops atrox

医学 随机对照试验 低强度激光治疗 肌酸激酶 抗蛇毒血清 环境化 外科 麻醉 激光治疗 毒液 内科学 激光器 生态学 物理 光学 生物
作者
Érica da Silva Carvalho,Andrea Renata do Nascimento Souza,Dessana Francis Chehuan Melo,Altair Seabra de Farias,Bruna Barbosa de Oliveira Macedo,Marco Aurélio Sartim,Mariela Costa Caggy,Beatriz de Alcântara Rodrigues,Gabriela Salini Ribeiro,Heloísa Nunes Reis,Felipe Queiroz Araújo,Iran Mendonça da Silva,André Sachett,Vanderson de Souza Sampaio,Antônio Alcirley da Silva Balieiro,Stella Regina Zamunér,João Ricardo Nickenig Vissoci,Lioney Nobre Cabral,Wuelton Marcelo Monteiro,Jacqueline de Almeida Gonçalves Sachett
出处
期刊:JAMA Internal Medicine [American Medical Association]
卷期号:184 (1): 70-70 被引量:4
标识
DOI:10.1001/jamainternmed.2023.6538
摘要

Importance Bothrops venom acts almost immediately at the bite site and causes tissue damage. Objective To investigate the feasibility and explore the safety and efficacy of low-level laser therapy (LLLT) in reducing the local manifestations of B atrox envenomations. Design, Setting, and Participants This was a double-blind randomized clinical trial conducted at Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, in Manaus, Brazil. A total of 60 adult participants were included from November 2020 to March 2022, with 30 in each group. Baseline characteristics on admission were similarly distributed between groups. Data analysis was performed from August to December 2022. Intervention The intervention group received LLLT combined with regular antivenom treatment. The laser used was a gallium arsenide laser with 4 infrared laser emitters and 4 red laser emitters, 4 J/cm 2 for 40 seconds at each application point. Main Outcomes and Measures Feasibility was assessed by eligibility, recruitment, and retention rates; protocol fidelity; and patients’ acceptability. The primary efficacy outcome of this study was myolysis estimated by the value of creatine kinase (U/L) on the third day of follow-up. Secondary efficacy outcomes were (1) pain intensity, (2) circumference measurement ratio, (3) extent of edema, (4) difference between the bite site temperature and that of the contralateral limb, (5) need for the use of analgesics, (6) frequency of secondary infections, and (7) necrosis. These outcomes were measured 48 hours after admission. Disability assessment was carried out from 4 to 6 months after patients’ discharge. P values for outcomes were adjusted with Bonferroni correction. Results A total of 60 patients (mean [SD] age, 43.2 [15.3] years; 8 female individuals [13%] and 52 male individuals [87%]) were included. The study was feasible, and patient retention and acceptability were high. Creatine kinase was significantly lower in the LLLT group (mean [SD], 163.7 [160.0] U/L) 48 hours after admission in relation to the comparator (412.4 [441.3] U/L) ( P = .03). Mean (SD) pain intensity (2.9 [2.7] vs 5.0 [2.4]; P = .004), circumference measurement ratio (6.6% [6.6%] vs 17.1% [11.6%]; P < .001), and edema extent (25.9 [15.0] vs 45.9 [24.7] cm; P = .002) were significantly lower in the LLLT group in relation to the comparator. No difference was observed between the groups regarding the mean difference between the bite site temperature and the contralateral limb. Secondary infections, necrosis, disability outcomes, and the frequency of need for analgesics were similar in both groups. No adverse event was observed. Conclusions and Relevance The data from this randomized clinical trial suggest that the use of LLLT was feasible and safe in a hospital setting and effective in reducing muscle damage and the local inflammatory process caused by B atrox envenomations. Trial Registration Brazilian Registry of Clinical Trials Identifier: RBR-4qw4vf
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
Owen应助<小天才>采纳,获得10
2秒前
英姑应助九思采纳,获得10
3秒前
4秒前
4秒前
4秒前
5秒前
量子星尘发布了新的文献求助10
6秒前
JamesPei应助机灵的囧采纳,获得10
7秒前
llll发布了新的文献求助10
7秒前
orixero应助xmh采纳,获得10
7秒前
wq1020发布了新的文献求助10
9秒前
10秒前
皮皮蛙完成签到,获得积分10
10秒前
情怀应助常芹采纳,获得10
11秒前
肖肖发布了新的文献求助10
11秒前
11秒前
11秒前
12秒前
缥缈问柳完成签到,获得积分10
12秒前
12秒前
明理念桃完成签到,获得积分10
13秒前
13333发布了新的文献求助10
14秒前
Ava应助不吃意面的老番茄采纳,获得10
16秒前
16秒前
zhao完成签到 ,获得积分10
18秒前
19秒前
19秒前
19秒前
xmh完成签到,获得积分10
20秒前
什么也难不倒我完成签到 ,获得积分10
20秒前
21秒前
孟一发布了新的文献求助30
21秒前
22秒前
小幻完成签到,获得积分10
22秒前
好宝宝发布了新的文献求助10
23秒前
23秒前
乐天完成签到,获得积分10
24秒前
wuniuniu发布了新的文献求助10
24秒前
Happyness应助13333采纳,获得30
25秒前
25秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3988838
求助须知:如何正确求助?哪些是违规求助? 3531250
关于积分的说明 11252914
捐赠科研通 3269838
什么是DOI,文献DOI怎么找? 1804820
邀请新用户注册赠送积分活动 881943
科研通“疑难数据库(出版商)”最低求助积分说明 809028